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An increasing number of Nova Scotians are discontented with health care in their province, which likely surprises no one. But it’s still sobering news for the provincial government.

In fact, the number of Nova Scotians who rank the overall quality of health care as poor has more than doubled since 2015, the year the government merged nine district authorities into one big Nova Scotia Health Authority.

After reviewing results of the public perceptions survey commissioned by the authority last year, the NSHA board of directors, at its November meeting, agreed that “greater proactive communication and public education is required.”

Perceptions can be changed, but it’s neither easy nor cheap, especially when those perceptions accurately reflect reality. In that case, it’s likely a better idea to save on PR and spend the money fixing something that’s got people upset in the first place.

And you don’t need to dig deep into the survey results to discover that what’s got Nova Scotians upset is doctors or, more accurately, inadequate access to them, particularly family docs.

The research – a survey of 800 adult Nova Scotians, spread evenly across the NSHA’s four geographic zones and conducted last June by Corporate Research Associates – suggests Nova Scotians equate the quality of health care with access to doctors.

“Nova Scotia’s family doctor shortage is clearly an issue that resonates across the province with 40 per cent mentioning it as the most important health service not readily available in their community. Access to doctors is perceived to be the greatest challenge currently facing Nova Scotia’s health care system,” the NSHA wrote in a nice email that arrived with the survey results.

While it may warm the cockles of some family physicians’ hearts to hear that Nova Scotians either cherish or miss them – depending on the circumstances of the individual – many family docs will tell you they feel decidedly unappreciated by the NSHA and the Liberal government that made it.

The health authority may never recover from the terrible first impression it left with doctors after senior officials of the then-new authority went on tour with an ill-conceived message for family docs. We may never know for sure exactly what was said, but the docs heard a threat – “don’t get comfortable ... there’s a new sheriff in town.”

The heavy hand laid on by the NSHA — it has since evolved a lighter touch — was the insult, the injury comes with the paycheque that reminds Nova Scotia’s family physicians they remain among the lowest paid in the nation.

But back to the survey.

The results show that 21 per cent of Nova Scotians rate the overall quality of health care as poor. An identical 21 per cent rate the quality of care as good to excellent. That doesn’t seem too bad, until you look back a few years.

The change in perceptions since 2015 should grab the government’s attention. Four years ago, only 10 per cent of Nova Scotians rated the quality of health care as poor, and 34 per cent said it was good to excellent.

The math is easy, so I’ll do it. Since 2015, the number of people who rate health care as poor increased by 11 percentage points, while Nova Scotians who rate the system as good to excellent fell by 13. If that’s a trend and it continues, the governing Liberals have big trouble.

The survey contains a few more interesting nuggets, like the “notable minorities.” While the vast majority of Nova Scotians believe access to health care is holding steady and will be there when they need it, a “notable minority” of people (22 per cent) believe access deteriorated in the past year, and another “notable minority” (26 per cent) believe they won’t get care when they need it.

The NSHA says the 2018 public perceptions survey will set the baseline against which they’ll measure future progress. So they expect — or hope — the results will improve by 2020 when they do the survey next. Something tells me it will take more than “greater proactive communication and public education” to get that job done.